Sr Representative, Accident Benefits Claims - Waterloo, Canada - Definity Careers

Description

Reporting to the Team Leader, Accident Benefit Claims, you are accountable for investigating, evaluating and settling Accident Benefit claims

What can you expect in this role?

• Report to the Team Leader, Accident Benefit Claims, while investigating, evaluating and settling accident benefit claims in accordance with the Insurance Act
• Securing details of claims by corresponding with claimants and/or representatives
• Assessing coverage eligibility and reviewing and applying interpretations of policy wordings in the resolution of coverage issues
• Applying applicable Priority Rules chart to each claim file
• Processing income replacement, non-earner, and attendant care claims
• Reserving files appropriately after assessing claim
• Maintaining detailed file records on an electronic claims system
• Processing payments after confirming benefits, eligibility and reserves
• Coordinating the most effective course of action for claims
• Confirming collateral benefits
• Responding to claimant correspondence and accident benefit forms in accordance with the applicable legislation
• Reviewing and approving, when appropriate, treatment plans for claimant rehabilitation
• Arranging insurer examinations to determine benefits eligibility
• Preparing referral packages and obtaining the necessary medical information for insurer examinations
• Responding to assessment recommendations
• Other duties as assigned

What do you bring to the role?

• University degree, college diploma in related field or the CIP designation
• Minimum 4-5 years of claims handling experience
• Proficient in MS Word and Excel
• Professional, friendly and courteous in all interactions, whether with customers or co-workers
• Able to perform well in a busy operation and remain calm under pressure
• Team player adaptable to a changing environment
• Strong written and verbal communication skills

Salary range is $$54,800 - $100,800